title: Retrohepatic vena cava deroofing in living donor liver transplantation for caudate hepatocellular carcinoma.
abstract: The removal of tumor together with the native liver in living donor liver transplantation for hepatocellular carcinoma is challenged by a very close resection margin if the tumor abuts the inferior vena cava. This is in contrast to typical deceased donor liver transplantation where the entire retrohepatic inferior vena cava is included in total hepatectomy. Here we report a case of deroofing the retrohepatic vena cava in living donor liver transplantation for caudate hepatocellular carcinoma. In order to ensure clear resection margins, the anterior portion of the inferior vena cava was included. The right liver graft was inset into a Dacron vascular graft on the back table and the composite graft was then implanted to the recipient inferior vena cava. Using this technique, we observed the no-touch technique in tumor removal, hence minimizing the chance of positive resection margin as well as the chance of shedding of tumor cells during manipulation in operation.
authors.affiliation: Department of Surgery; State Key Laboratory for Liver Research, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China. seechingchan@gmail.com.
authors.forename: See Ching
authors.initials: SC
authors.lastname: Chan
authors.forename: William W
authors.initials: WW
authors.lastname: Sharr
authors.forename: Tan To
authors.initials: TT
authors.lastname: Cheung
authors.forename: Albert C Y
authors.initials: AC
authors.lastname: Chan
authors.forename: Simon H Y
authors.initials: SH
authors.lastname: Tsang
authors.forename: Kenneth S H
authors.initials: KS
authors.lastname: Chok
authors.forename: Kin Chung
authors.initials: KC
authors.lastname: Leung
authors.forename: Chung Mau
authors.initials: CM
authors.lastname: Lo
mesh_terms: D001706:Biopsy; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D018365:Neoplasm, Residual; D010690:Phlebography / Q000379:methods; D011093:Polyethylene Terephthalates; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D011093:Polyethylene Terephthalates